For decades, despite the mounting evidence of health and social harms stemming directly from the global “war on drugs,” drug policy reform has been slow in coming. On the eve of the XVIII International AIDS Conference (AIDS 2010), there seems to be a great deal of enthusiasm in the air about the potential for a tectonic shift in the global drug policy paradigm away from the drug war and towards evidence-based approaches to address illegal drugs.

Reflecting upon the factors that have created the moment in history, that is about to unfold over the coming week in Vienna, it is difficult to single out what got us here:

Certainly the raging HIV epidemic in Russia, stemming largely from the ongoing illegality of evidence-based prevention and treatment tools like methadone maintenance therapy, has mobilized many in the public health, HIV and addiction medicine communities.

The horrible violence in Mexico, with over 22,000 people dead since 2007, has also drawn global attention to the way in which drug prohibition enriches organized crime and fuels related violence.

The explosion of opium production in Afghanistan.

Increasing questions about the financial viability of US states, like California, which spend more of their tax base on incarceration than post-secondary education

The efforts to silence individual scientists who have spoken out against public policy based on ideology instead of evidence.

All these recent events sitting atop the decades of human rights abuses, corruption, violence, disease and death – that have been borne directly out of the drug war – have somehow created a perfect storm of policy-attributable harms that appear to be moving the scientific and public health communities to finally and collectively state: “a full policy reorientation is needed.”

If you have not done so already, I encourage you to read the Vienna Declaration and add your voice to this global call for change.

Evan Wood MD, PhD is the co-director of the Urban Health Research Initiative at the BC Centre for Excellence in HIV/AIDS and the founder of the International Centre for Science in Drug Policy.